Eczema & Psoriasis
Eczema and Psoriasis are 2 of the common chronic skin conditions still occurring today.- Eczema is marked by red, inflamed, itchy skin that can form small blisters and cause bleeding.
- Psoriasis is marked by red, itch, scaly patches of skin.
There are 5 main types of Psoriasis:
- Psoriasis vulgaris–most common type; red papules or rash which turns into a flake. The surface is covered with multi-layer gray or silver white scales;
- Intertriginous psoriasis–usually found in the folding parts such as armpits and groin, usually without scales,
- Guttate psoriasis–usually on the torso of children; mostly after a streptococcal infection of the upper respiratory tract.
- Pustular psoriasis–pustules mostly on the palm and fingertips. The pustules are filled with non-infectious pus.
- Erythrodermic psoriasis–most serious. Causes lowering of body temperature, hypoproteinemia and heart failure
The etiology of both diseases can be quite similar. Redness and inflammation indicate Bile (Heat) or Heat in the Blood. If the person feels unwell, has poor quality or dirty looking skin, boils, swollen glands and foul breath etc., it indicates there is also Toxicity. If there is more fluid and moisture and the redness is more pale, it shows Damp or Phlegm. Cases with scarring, very dry scaly skin and skin deformity indicate Melancholy, classed as Wind-Phlegm in Ayurveda and TCM.
Psoriasis was classified traditionally in a group of skin diseases of dryness with scaling. The Arab physicians including Rhazes agreed excess Melancholy humor caused the chronic dryness. If the Melancholy is from burnt Humors, there would be scaling and flaking of scales ‘like Mica’. Excess heat causes the burning and Itching. The importance of judicious purging in such chronic skin diseases was exemplified by Arab physicians. Modern research has shown bacterial endo-toxins accumulating in the intestines can be associated with some cases of Psoriasis, suggesting the use of purging medicines to be justified. Nevertheless, some of the most impressive radical ‘cures’ that you can witness will be after the use of the right purging medicines in the right case.
A review of more than 28,000 cases of Psoriasis treated in Taiwan over a 10 year period show the most commonly prescribed TCM prescription to be Win Qing Yin (see below) while the most commonly prescribed single herb was Dictamnus Bai Xian Pi (White Dittany). (Read the abstract here.)
Win Qing Yin is a combination of 2 Chinese formulas:
- Si Wu Tang +
- Huang Lian Jie Du Tang
Some practitioners add Rhubarb (Da Huang) especially if using in powder form. This formula is widely used for Eczema and Psoriasis.
Another review looked at the use of topical herb washes and baths for Psoriasis in TCM. It found Sophora Ku Shen and Lithospermum Zi Cao were the most commonly used herbs. (Research below)
External Treatment
WASHES:
1. Plantain leaf, Comfrey, Slippery Elm, Calendula
2. Chickweed, Camomile, Marshmallow
3. Violet, Plantain, Cleavers, Licorice
SALVES AND OINTMENTS:
1. Plantain leaf, Comfrey leaf, Chickweed, Elder flower with Wax and Olive oil.
2. Fumitory, Violet, Red Clover, Marshmallow, Licorice
POPOV’S ECZEMA TREATMENT.
Russian physician and naturopath A. Popov promoted his treatment for Eczema as follows:
Put 4 oz. of powdered Burdock root into a pot with 5 liters of boiling water, and continue boiling for 20 minutes. Allow to cool to 39-40 degrees C. Next fold a sheet in quarters, soak the sheet in the decoction, gently sqeeze out the excess, then wrap the sheet around the patient from armpit to feet. Wrap the patient in another dry sheet and lie them down for 1-2 hours (they may sleep). It can be repeated for up to 6 days, then used as needed. It is best done before bed. Healing usually begins after the second day.
Herbs Commonly used in the Treatment of Eczema and Psoriasis
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Aloe Birthwort Burdock Calendula Camomile Cassia tora |
Catechu Eclipta alba Fenugreek Fumitory Heartsease |
Hedychium Lavender Licorice Mallow Mesua |
Neem Nigella Sandalwood Sarsaparilla Violet |
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Western Tradition |
Chinese Classification |
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Simples: |
Simples: |
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Rehmannia Sheng Di Paeonia Bai Shao Psoralea Bu Gu Zhi Lithospermum Zi Cao Zedoary (E Zhu) Indigo (Qing Dai) |
Sophora Ku Shen Paeonia rubra Chi Shao Paeonia Mu Dan Pi Tribulus seed Ci Ji Li Salvia (Dan Shen) Pit Viper (Bai Hua She) |
Formulas:
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General Decoction of Fumitory Compound Syrup of Fumitory Compound (Mesue) Syrup of Chicory and Rhubarb (Nicholas) Syrup of Hops Pills of Fumitory (Avicenna) Catholicum (Diacatholicum) (Nicholas) Hiera Logadii Electuary of Senna (Disenna) (Nicholas) Oil of Walnuts (topically) Oil of St. Johns wort Oil of St Johns wort Compound White Plaster of Ceruse Ointment of Elecampane Ointment of Roses Ointment of Calamine Ointment of Ceruse Camphorated Ointment of Sulphur Kaisor Guggulu Manjistha Kvatha (Madder Decoction) Nimbadi Chruna (Neem Powder) (Ayurveda) Heat / Bile Lime Water Syrup of Chicory and Rhubarb (Nicholas) Pills of Fumitory (Avicenna) Heat and Toxin Decoction for Skin Disease Syrup of Chicory and Rhubarb (Nicholas) Pills of Fumitory (Avicenna) Manjistha Kvatha (Madder Decoction) Nimbadi Chruna (Neem Powder) (Ayurveda) Wind-Phelgm Kaisor Guggulu Garuda 5 (Khyung Lnga) (Tibetan Medicine) Melancholy Pills of Fumitory (Avicenna) Pills of Fumitory and Senna (Unani) Pills of Azurite (Mesue) Pills of Lapis Lazuli (Mesue) Electuary for Scabies and Pruritis (Rhasis) Electuary of Senna (Disenna) (Nicholas) |
Wind Cold Acute Eczema, especially in children, pale red lesions, thick scales flaking off shed, minimal itching, dislikes cold, aggravated in winter, improves in summer, joint pain, a pale tongue with a thin coating. Gui Zhi Tang Wind and Heat Red lesions, scales thick, itchy, dislikes heat, worse in the heat or after hot or spicy food or alcohol, restlessness, thirst, dry stools, yellow urine, red tongue, yellow coating. Dang Gui Yin Zi Dan Zhi Xiao Yao San Fang Feng Tong Shen San Xi Jiao Di Huang Tang Xiao Feng San Damp Heat Dark red lesions, weeping or moist under scales, worsen in humid weather, heaviness in the chest, yellow urine, red tongue with thick yellow coat. Fang Feng Tong Sheng San Long Dan Xie Gan Tang Si Wu Tang + Huang Lian Jie Du Wan Toxic Heat Red lesions increasing quickly, fine scales with very red skin underneath, burning pain and itching, fever, thirst, yellow urine, deep red tongue with coating. Lian Qiao Bai Du Pian Si Wu Tang + Huang Lian Jie Du Wan Huang Lian Jie Du Tang Niu Huang Jie Du Tang Xian Fang Huo Ming Yin Blood Heat Red skin rash, skin bleeds easily, good complexion, full pulse, strong or excessive menstrual bleeding Si Wu Tang + Huang Lian Jie Du Wan Qing Ying Tang Blood Stasis with Blood deficiency Chronic cases with scarring, fixed patches of dry skin with dark color, skin is dull, nail beds and lips may be dark or pale, pulse is weak (more blood deficient) or choppy (more blood stasis). Tao Hong Si Wu Tang Huo Luo Xiao Ling Dan Yin Deficiency Chronic cases, especially in the elderly or weak, pale red lesions with thin scales, not very red, back pain, weakness extremities, dizziness, tinnitus, pale tongue with coating. Si Wu Tang Dang Gui Yin Zi Er Xian Tang Zhi Bai Di Huang Wan Mai Wei Di Huang Wan |
Special Formula
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Marjoon Ushba Senna 80 grams Red sandalwood White Sandalwood China root Damask Rose 60 grams each Cinnamon Cubeb Borage Dodder Polypody Sarsaparilla 40 grams each Belleric Myrobalan Indian Spikenard 20 grams each Chebulic Myrobalan 15 grams Black Myrobalan 10 grams White Sugar 2 kg This was studied and found to have a significant effect, especially when used with Roghan Hindi (below). (See research here) Roghan Hindi Neem 250 grams Copper Sulphate Litharge Tamarix Belleric Myrobalan Turmeric 10 grams each Mustard oil 250 mls. Prepare an oil for topical application. Ointmewnt for Tetter (Eczema and similar diseases) i. Cinnabar Make an ointment with Wax and Oil of Roses. ii. Cockle shell Sulphur Powder, mix with Vinegar and Apply. An Ointment of Paracelsus Plantain juice Houseleek juice Nightshade juice equal parts Oil of Litharge sufficient Add enough Oil of Litharge to form an Ointment. (114 Experiments and Cures of Paracelsus, 1652) |
Huo Xue San Yu Decoction Sparganium San Leng Zedoary (E Zhu) Peach kernel (Tao Ren) Safflower (Hong Hua) Spatholobus Ji Xue Teng Euonymus Gui Lian Yu Hedyotis Bai Hua She She Cao Salvia Dan Shen Citrus Chen Pi This was found comparable to acitretin (10 mg, b.i.d.), in the treatment of psoriasis vulgaris (see here) Cool the Blood and Detoxify Decoction China root (Tu Fu Ling) 30 grams Sophora flower Huai Mi 15 grams Lithospermum Zi Cao 10 grams Paris Chong Lou 9 grams Rehmannia Sheng Di 15 grams Dictamnus Bai Xian Pi 10 grams Paeonia Chi Shao Yao 10 grams Used for Blood Heat and Toxin type Eczema and Psoriasis. Blood Dryness Salvia Dan Shen 15 grams Angelica Dang Gui 15 grams Rehmannia Sheng Di 15 grams Ophiopogon Mai Men Dong 10 grams Scrophularia Xuan Shen 15 grams Spatholobus Ji Xue Teng 15 grams China root (Tu Fu Ling) 30 grams Blood Stasis Hedyotis Bai Hua She She Cao 30 grams Zedoary (E Zhu) 10 grams Euonymus Gui Jian Ju 10 grams Safflower (Hong Hua) 10 grams Spatholobus Ji Xue Teng 15 grams Peach kernel (Tao Ren) 10 grams Salvia Dan Shen 15 grams Herose capsules Ginger (Gan Jiang) Salvia Dan Shen Astragalus Huang Qi Cinnamon twig (Gui zhi) Paeonia Bai Shao Codonopsis Dang Shen Coix Yi Yi Ren This has been found most effective in plaque Psoriasis. Yin Xie Ling Decoction (PSORI-CM) Dang Gui Paeonia Bai Shao Chloranthus spicatus Jin Su Lan Prunus mume Wu Mei Rehmannia Sheng Di Huang Ligusticum Chuan Xiong Lithospermum Zi Cao Zedoary (E Zhu) China root (Tu Fu Ling) Licorice This formula was formulated by a famous Chinese Medicine dermatologist Guo-wei Xuan and has been widely used for Psoriasis for over 20 years. It can relieve symptoms and reduce relapse rate, (See here and here) PSORI-CM02 Turmeric Jiang Huang 2 parts Paeonia Bai Shao 3 parts China root (Tu Fu Ling) 5 parts Prunus mume Wu Mei 2 parts Sarcandra Zhong Jie Feng 5 parts This was studied in a mouse model of Psoriasis and found effective. (See here) Pulian ointment Phellodendron Huang Bai 50 grams Scutellaria Huang Qin 50 grams Vaseline (petroleum jelly) 400 grams Powder the herbs and add to melted vaseline, stirring until cool. This is often used for Eczema, Psoriasis, Herpes Simplex, Erythroderma, and has been proven effective. (see here) Yin Xie Ling Ointment Burnet (Di Yu) Scutellaria Huang Qin Phellodendrum Huang Bai This was found as effective as the topical application of Dichlorodiethyl sulfide (see here) Qing Dai Ointment Indigo (Qing Dai) Scutellaria Huang Qin Phellodendrum Huang Bai This has been found effective in pediatric psoriasis. |
Research:
HERBS–Medicinal plants used in treatment of inflammatory skin diseases
INDIGO:
A traditional Chinese remedy points to a natural skin habitat: indirubin (indigo naturalis) for psoriasis and the Malassezia metabolome.
–An alkaloid-rich phytopharmaceutical prepared from Qing Dai against IL-17A-induced psoriasis.
–Anti-psoriatic effects of indigo naturalis on the proliferation and differentiation of keratinocytes with indirubin as the active component.
–Clinical assessment of patients with recalcitrant psoriasis in a randomized, observer-blind, vehicle-controlled trial using indigo naturalis.
–Comparison of indirubin concentrations in indigo naturalis ointment for psoriasis treatment: a randomized, double-blind, dosage-controlled trial.
–Indirubin ameliorates imiquimod-induced psoriasis-like skin lesions in mice by inhibiting inflammatory responses mediated by IL-17A-producing γδ T cells.
–Clinical efficacy and IL-17 targeting mechanism of Indigo naturalis as a topical agent in moderate psoriasis
–A Comprehensive Review of the Chemistry, Pharmacokinetics, Pharmacology, Clinical Applications, Adverse Events, and Quality Control of Indigo Naturalis
OTHER:
–Induction of apoptosis underlies the Radix Rubiae-mediated anti-proliferative action on human epidermal keratinocytes: implications for psoriasis treatment.
–Deciphering the Mechanism of Action of Wrightia tinctoria for Psoriasis Based on Systems Pharmacology Approach.
–Anti-psoriatic potential of Solanum xanthocarpum stem in Imiquimod-induced psoriatic mice model.
FORMULAS
–Traditional Chinese Medicine Use among Patients with Psoriasis in Taiwan: A Nationwide Population-Based Study.
–Chinese Medicine Formula PSORI-CM02 Alleviates Psoriatic Dermatitis via M-MDSCs and Th17 Crosstalk
–Topical herbal formulae in the management of psoriasis: systematic review with meta-analysis of clinical studies and investigation of the pharmacological actions of the main herbs.
–Clinical evaluation of efficacy of Majoon Ushba and Roghane Hindi in the management of psoriasis: A randomized single-blind, placebo-controlled study.
–A systems pharmacology perspective to decipher the mechanism of action of Parangichakkai chooranam, a Siddha formulation for the treatment of psoriasis.
–Clinical efficacy of Shodhana Karma and Shamana Karma in Mandala Kushtha (Psoriasis).
–A non-inferiority randomized controlled clinical trial comparing Unani formulation & psoralen plus ultraviolet A sol in chronic plaque psoriasis
–Chinese Herbal Medicine for Psoriasis: Evidence From 11 High-Quality Randomized Controlled Trials
–Psoriasis therapy by Chinese medicine and modern agents
TOPICAL:
–Topical Botanical Agents for the Treatment of Psoriasis: A Systematic Review.
–Plant extracts for the topical management of psoriasis: a systematic review and meta-analysis.